en شانه / آرنج Shoulder / Elbow گزارش مورد Case Report <div style="text-align: justify;"><strong>Background</strong>: Pure fractures of the anatomical neck of the humerus are rare and potentially serious injuries due to the risk of complications such as avascular necrosis (AVN) and functional impairment. When associated with lesser tuberosity fractures, management becomes more complex and requires precise surgical intervention.&nbsp;<br> <strong>Case Presentation</strong>: We report two cases of young men who sustained a shoulder injury after falling from a high place. Clinical examination revealed severe pain, swelling, and restricted range of motion. Radiographic and computed tomography (CT) imaging demonstrated a fracture of the anatomical neck of the humerus with an associated lesser tuberosity fracture. The patients underwent open reduction and internal fixation via a deltopectoral approach. The humeral head was stabilized using Herbert screws, and the lesser tuberosity was fixed with Ethibond sutures. Postoperative rehabilitation included early passive motion and progressive physiotherapy. Follow-up at 3 and 6 months showed satisfactory fracture union, improved shoulder function, and no evidence of AVN.<br> <strong>Conclusion</strong>: Early diagnosis, appropriate surgical fixation by an experienced shoulder surgeon, and structured rehabilitation can result in favorable functional outcomes in complex proximal humerus fractures involving the anatomical neck and lesser tuberosity.</div> Proximal humerus fracture, Anatomical neck fracture, Lesser tuberosity, Internal fixation, Shoulder injury 25 30 http://jros.iums.ac.ir/browse.php?a_code=A-10-2736-3&slc_lang=en&sid=1 Mojtaba Khajeh Alizadeh Attar mojtaba.attar75@gmail.com 10031947532846009085 10031947532846009085 No Bone and Joint Reconstruction Research Center, School of Medicine, Shafayahyaeian Hospital, Iran University of Medical Sciences, Tehran, Iran. Morteza Nakhaei Amroodi drmna@yahoo.com 10031947532846009086 10031947532846009086 No Bone and Joint Reconstruction Research Center, School of Medicine, Shafayahyaeian Hospital, Iran University of Medical Sciences, Tehran, Iran. Mohammadreza Bahaeddini mrbahaeddini@yahoo.com 10031947532846009087 10031947532846009087 No Bone and Joint Reconstruction Research Center, School of Medicine, Shafayahyaeian Hospital, Iran University of Medical Sciences, Tehran, Iran. Mohammadmehdi Mahdavifar Mahdavifarmohammadmehdi@gmail.com 10031947532846009088 10031947532846009088 No Bone and Joint Reconstruction Research Center, School of Medicine, Shafayahyaeian Hospital, Iran University of Medical Sciences, Tehran, Iran. Pouria Tabrizian tabrizian.pouria@gmail.com 10031947532846009089 10031947532846009089 Yes Bone and Joint Reconstruction Research Center, School of Medicine, Shafayahyaeian Hospital, Iran University of Medical Sciences, Tehran, Iran.